Directs the office of alcoholism and substance abuse services to provide for an ombudsman for substance use disorder insurance coverage to receive complaints about and make recommendations on insurance coverage for substance use disorder treatment and care.
STATE OF NEW YORK
________________________________________________________________________
8002
IN SENATE
March 19, 2018
___________
Introduced by Sens. AMEDORE, HANNON, AKSHAR, JACOBS -- read twice and
ordered printed, and when printed to be committed to the Committee on
Alcoholism and Drug Abuse
AN ACT to amend the mental hygiene law, in relation to directing the
office of alcoholism and substance abuse services to provide an
ombudsman for substance use disorder insurance coverage
The People of the State of New York, represented in Senate and Assem-bly, do enact as follows:
1 Section 1. Section 19.07 of the mental hygiene law is amended by
2 adding a new subdivision (l) to read as follows:
3 (l) (1) The office shall establish, either directly or through
4 contract, an ombudsman for substance use disorder insurance coverage.
5 Such ombudsman shall have expertise in substance use disorder treatment
6 and advocacy, experience with insurance coverage requirements, and such
7 other qualifications as shall be determined by the commissioner, in
8 consultation with the superintendent of financial services.
9 (2) The ombudsman for substance use disorder insurance coverage shall:
10 (i) identify, accept, investigate, refer and resolve complaints that
11 are made by or on behalf of consumers relative to health insurance
12 coverage of and access to initial and continuing substance use disorder
13 care, including medication assisted treatment, both inpatient and outpa-
14 tient;
15 (ii) accept, investigate, refer and resolve complaints that are made
16 by treatment providers relative to health insurance coverage of and
17 reimbursement for initial or continuing substance use disorder care,
18 including medication assisted treatment, both inpatient and outpatient;
19 (iii) accept, investigate, refer and resolve complaints that are made
20 by or on behalf of consumers or by providers relative to network adequa-
21 cy for access to and continuing substance use disorder care, including
22 medication assisted treatment, both inpatient and outpatient; and
23 (iv) make recommendations to the commissioner and the superintendent
24 of financial services biennially beginning October first, two thousand
25 nineteen, on regulatory and/or statutory changes necessary to ensure
26 access to appropriate care, and such recommendations shall be shared
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[] is old law to be omitted.
LBD14734-02-8
S. 8002 2
1 with the legislature upon issuance. Such recommendations may also
2 include whether the ombudsman role should be extended to include broader
3 behavioral health insurance complaints and concerns.
4 § 2. This act shall take effect on the ninetieth day after it shall
5 have become a law.